Stephen J Brummett, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Phoenix, OR

NPI 1992961239 · NPPES record last updated Mar 20, 2015

Key facts

NPI
1992961239
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
482 Elm St
Phoenix, OR 97535
Phone
(541) 535-3414
NPI assigned
Aug 6, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150417001661 OR Practitioner - Clinical Social Worker 0840518072 Practice locations: Phoenix, OR

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

482 Elm St
Phoenix, OR 97535

Mailing address

482 Elm Street
Medford, OR 97535
Phone (541) 535-3414

Other providers in Phoenix, OR

All providers in Phoenix, OR · Clinical Social Worker in Oregon

Sources for this page

Verify at the official NPI Registry.